Stripping of failing haemodialysis catheters using the Ampltaz gooseneck snare

被引:38
作者
Rockall, AG
Harris, A
Wetton, CWN
Taube, D
Gedroyc, W
AlKutoubi, MA
机构
[1] ST MARYS HOSP,DEPT RADIOL,LONDON,ENGLAND
[2] ST MARYS HOSP,DEPT NEPHROL,LONDON,ENGLAND
关键词
D O I
10.1016/S0009-9260(97)80255-3
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
The development of a fibrin sheath at the tip of a long-term haemodialysis catheter mag lead to deteriorating blood flow rates, resulting in inadequate haemodialysis. Restoration of functional patency has been described using the technique of percutaneous fibrin sheath stripping (PFSS) using a wire snare de rice. Our purpose was to assess this technique within an established renal vascular access ser, ice. All catheters referred for the assessment of low blood flow rates on dialysis were considered for the procedure. Initial fluoroscopic assessment of the catheter was followed by stripping of the tip of the catheter using a gooseneck snare, Seventeen of 22 well-positioned catheters undergoing a single PFSS attempt were restored to function with a median prolongation of patency of 1.25 months, Two catheters underwent a second PFSS procedure providing additional patency. Nineteen of a total of 24 (79%) PFSS procedures successfully restored catheter function, Seven catheters with poorly positioned tips or a kink were not restored to functional patency using PFSS, Two patients developed a puncture site haematoma, No patient developed symptoms of pulmonary emoblism, In conclusion, PFSS restored function in 79% of attempts in well positioned catheters, The method is technically straightforward, with a low complication rate and has become a routine part of the renal vascular access service.
引用
收藏
页码:616 / 620
页数:5
相关论文
共 26 条
[1]   MAJOR COMPLICATIONS OF ANGIOACCESS SURGERY [J].
BALLARD, JL ;
BUNT, TJ ;
MALONE, JM ;
SHAH, DM ;
SCHANZER, H ;
GARFINKLE, S .
AMERICAN JOURNAL OF SURGERY, 1992, 164 (03) :229-232
[2]   DIAGNOSIS OF THROMBOSIS BY CATHETER PHLEBOGRAPHY AFTER PROLONGED CENTRAL VENOUS CATHETERIZATION [J].
BRISMAR, B ;
HARDSTEDT, C ;
JACOBSON, S .
ANNALS OF SURGERY, 1981, 194 (06) :779-783
[3]   NONINFECTIOUS COMPLICATIONS OF LONG-TERM CENTRAL VENOUS CATHETERS - RADIOLOGIC EVALUATION AND MANAGEMENT [J].
CASSIDY, FP ;
ZAJKO, AB ;
BRON, KM ;
REILLY, JJ ;
PEITZMAN, AB ;
STEED, DL .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1987, 149 (04) :671-675
[4]   Fibrin sleeve stripping for salvage of failing hemodialysis catheters: Technique and initial results [J].
Crain, MR ;
Mewissen, MW ;
Ostrowski, GJ ;
PazFumagalli, R ;
Beres, RA ;
Wertz, RA .
RADIOLOGY, 1996, 198 (01) :41-44
[5]   FACTORS AND COMPLICATIONS AFFECTING CATHETER AND TECHNIQUE SURVIVAL WITH PERMANENT SINGLE-LUMEN DIALYSIS CATHETERS [J].
DEMEESTER, J ;
VANHOLDER, R ;
DEROOSE, J ;
RINGOIR, S .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 1994, 9 (06) :678-683
[6]  
DEMOOR B, 1994, ARTIF ORGANS, V18, P293
[7]   WILL IATROGENIC PULMONARY EMBOLIZATION BE OUR PULMONARY EMBARRASSMENT [J].
DOLMATCH, BL ;
GRAY, RJ ;
HORTON, KM .
RADIOLOGY, 1994, 191 (03) :615-617
[8]  
Dunea G, 1991, ASAIO Trans, V37, pM276
[9]   5 YEARS EXPERIENCE WITH THE QUINTON PERMCATH FOR VASCULAR ACCESS [J].
GIBSON, SP ;
MOSQUERA, D .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 1991, 6 (04) :269-274
[10]   THROMBOLYSIS OF BLOCKED HEMODIALYSIS CATHETER USING RECOMBINANT TISSUE-TYPE PLASMINOGEN-ACTIVATOR [J].
HANNAH, A ;
BUTTIMORE, AL .
NEPHRON, 1991, 59 (03) :517-518